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Strontium is in the periodic table just below calcium.
Like calcium, strontium has two positive charges in its ionic form.
Because of its chemical similarity to calcium, strontium can replace calcium
to some extent in various biochemical processes in the body including
replacing a small proportion of the calcium in hydroxyapatite crystals of
calcified tissues such as bones and teeth. Strontium in these crystals
imparts additional strength to these tissues. Strontium also appears
to draw extra calcium into bones. When rats or guinea pigs are fed increased
amounts of strontium, their bones and teeth became thicker and stronger.

Strontium has been safely used as a substance for more than a hundred
years. It was first listed in Squires Companion to the British
Pharmacopoeia in 1884. Subsequently, strontium was used
therapeutically in the United States and Europe. As late as 1955,
strontium compounds were still listed in the Dispensatory of the United
States of America. For decades in the first half of the twentieth
century, strontium salts were administered in dosages of 200 to 400 mg per
day without toxic effects.

Strontium and Bone StrengthStrontium tends to accumulate in bone -- especially where active remodeling
is taking place. In 1959, researchers at the Mayo Clinic investigated
the effect of strontium in 32 individuals in need of bone supporting
materials.1 Each person received 1.7 grams of strontium per day as strontium
lactate. Eighty-four percent of the people reported marked relief, and
the remaining 16 percent experienced moderate improvement. No
significant side effects were seen, even with prolonged (up to three years)
administration of strontium. X-rays taken at the beginning and end of
the study showed possible increased bone mass in 78 percent of the
cases. This is not surprising, considering the symptomatic improvement
reported by the patients. Unfortunately, measurement of bone mass in 1959
was pretty crude, leading the researchers to qualify their interpretation of
the X-rays. Sophisticated tests such as dual photon absorptiometry and CT
scanning as used today were not available at the time this study was
conducted.

Nevertheless, because of the "strontium scare" of the 1950s,
little follow-up was conducted until nearly 30 years later. In 1986,
scientists administered 0.27 percent strontium to mice in their drinking
water.

This resulted in an
increased rate of bone formation and decreased rate of
bone resorption.2 In another study, rats given
extra strontium showed increased bone formation and
greater bone density than rats fed a control diet.
These reports suggested that the amount of strontium we
ingest may support bone mass.8

In 1985, Dr. Stanley C. Skoryna of McGill University in Montreal conducted a
small-scale study that pointed to a potential role for strontium in the
treatment of humans.3 Three men and three women with compromised bones
were each
given 600 to 700 mg per day of strontium in the form of strontium carbonate.
Bone biopsies were taken in each patient at the iliac crest (hip bone),
before and after six months of treatment with strontium. Biopsy samples
showed a 172 percent increase in the rate of bone formation after ingesting strontium, with no change in bone resorption.
The people receiving strontium
remarked that the pain in their bones were not as pronounced and their ability to
move around had improved. Recently, interest
in strontium has been rekindled by a number of studies using the
strontium salt of ranelic acid (strontium ranelate). A large
multi-center trial known as the strontium ranelate (SR) for
treatment of bone conditions trial was designed to
investigate the efficacy and safety of different doses of strontium
in postmenopausal women.4

The study included 353 women with at least one previous
vertebral fracture and low scores of lumbar bone density. The
women received placebo or strontium in doses of 170, 340 or 680 mg per day
for two years. The scientists evaluated lumbar and hip bone mineral
density (BMD) using dual-energy X-ray absorptiometry (DXA).
They also determined the incidence of new vertebral fractures, as
well as several biochemical markers of bone metabolism. Lumbar bone
mineral density (BMD) increased in a dose-dependent manner as shown
in Figure 1. Also, there was a significant reduction in the number of patients with new
vertebral fractures in the second year of the group receiving the 680 mg per
day dose. In the 680 mg per day group, there was also a significant positive
change in markers of bone metabolism. The authors concluded that the 680 mg
per day dose offered the best combination of efficacy and safety, and stated
without equivocation that strontium ranelate supported vertebral BMD.

A much larger trial by the same research team included 1,649
postmenopausal women. These subjects received 2 grams per day of strontium
ranelate (providing 680 mg strontium) or placebo for three years.5
Calcium
and vitamin D supplements were also given to both groups before and during
the study. Women in the
strontium group noted a risk reduction of 49 percent in the first year of
treatment and 41 percent during the three-year study period. Women in the
strontium group increased lumbar bone mineral density by an average of 14.4
percent and femoral neck BMD an average of 8.3 percent. The authors
concluded treatment of postmenopausal women with strontium
ranelate leads to bone and vertebral support.

One of the largest studies on strontium ranelate, published in the January
30, 2006 online addition of the journal Bone, investigated its effects on
more than 7,000 postmenopausal women.6 After one year and
three years, strontium ranelate proved significant as an anti-fracture agent compared with
a placebo. After one year, the risk of new vertebral fractures was
reduced by 49 percent and after three years, by 41 percent in women taking
the strontium ranelate. In addition, the relative risk of vertebral
fracture was significantly reduced by 52 percent after 1 year and by 38
percent over 3 years in the strontium ranelate group compared with placebo.
Strontium ranelate also significantly decreased the relative risk of
vertebral fractures by 45 percent in patients without vertebral
fracture over 3 years compared to placebo. Bone mineral density also increased during 3 years of treatment with strontium ranelate in comparison
with placebo. Strontium ranelate was well tolerated throughout the
entire duration of the clinical trials, according to the authors.

Thus, strontium ranelate, 2 grams per day
orally, is a new, effective, and safe treatment for postmenopausal women in
reducing vertebral fracture risk in patients with or
without a history of vertebral fracture.

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